A dental crown is a tooth-shaped cap fully covering the tooth underneath. It is a great way to strengthen damaged teeth; restoring decayed or fractured teeth; and improving the appearance of your teeth. Crowns often last longer than direct fillings and provide superior aesthetic results, creating a healthy, durable and natural-looking smile.
You may need a dental crown in the following circumstances:
Tooth Decay – If your tooth suffers from severe tooth decay, a crown may be a more reliable long-term solution as the larger the filling required, the more weakened the tooth is . Where the success of fillings alone is questionable in the long-run, a crown (and a post and a core, if required) can protect the weakened tooth after fillings are done.
Cracked or Fractured Tooth – If a large part of your tooth is fractured and fillings are inadequate, a crown may be needed to protect it, ensuring that pressure is evenly distributed on the tooth. This can help to prevent any crack or fracture from being aggravated or enlarged.
Ineffective fillings – If your fillings have failed or have chipped off, although they can be repaired, there is a high chance that they will wear off again.
When a filling is required to be replaced, healthy tooth structure may be removed as a result of the procedure. This gradually weakens your tooth as the direct filling material is not as strong your natural tooth structure. Essentially, the more fillings you have, the weaker your tooth becomes.
By placing a crown at an early stage we can prevent the need for repeated fillings.
Aesthetics – Crowns can greatly improve the appearance of your tooth by changing the colour and shape of the tooth. Because there are many ways to improve your smile and facial aesthetics, we will discuss these with you to ensure you are getting the most suitable treatment.
After Root Canal Treatment – Crowns are recommended for strengthening root-filled molar teeth, as treated molars are weaker, and can fracture more easily when compared to living teeth with nerves and a good blood supply.
Bruxism – In some cases, crowns may be the only option for worn out teeth (caused by grinding of the teeth) to be restored back to their normal height.
While crowns are long-lasting and are great aesthetically, they are quite destructive to your natural teeth. Once your tooth is crowned, a crown will always be needed. Thus, having a crown is an important decision. At Dentist Mandy, we can help you balance all these important considerations and help you make an informed decision.
A crown may not be suitable in some circumstances. For example, if you suffer from periodontitis; if the tooth can’t be properly restored; or if the accessibility to the tooth becomes a problem.
Where there is tooth decay, a crown is not advisable until the decay has been treated and monitored, and the nerve and tooth have settled down. If the nerve is dead or severely aggravated, a root canal treatment may be carried out before having a crown.
These crowns provide the best aesthetics as they can be made to match the natural colours of your tooth, and are especially suitable for those with metal allergies. These days, there are many types of ceramic crown material to choose from. Depending on where the is crown to be placed, our dentists will choose a material that best that suits your circumstances.
As zirconia is very strong (even in thin sections), very little tooth material needs to be removed to fit a zirconia crown. A zirconia crown usually comes in a uniform shade and it may not produce the best aesthetic result in the way that an all-ceramic crown does.
As zirconia crowns are very hard (or even abrasive if not made appropriately), they can wear down opposing teeth, particularly natural teeth. Therefore, a zirconia crown is inadvisable for bruxists (people who grind their teeth together), as these grinding habits will increase the wear and tear a zirconia crown will cause to natural teeth. However, a zirconia crown will have little effect on opposing teeth if those teeth are already crowned, are an implant or are a partial denture.
If you have tooth-grinding habits, occlusal splints (a type of mouth-guard) should always be worn when sleeping.
Metal crowns, with porcelain fused to them, have been available for many decades and are still a popular option. The interior of the crown covering the tooth is made of metal, while the exterior is made of porcelain.
These crowns have a successful track record for both front and back teeth, as they combine the good looks of a porcelain crown with the strength of a metal crown.
However, with this type of crown, the porcelain can sometimes fracture off, exposing the metal core. The fractures of the porcelain layers are often purely aesthetic and not functional, as the metal layer remains strong and intact. These types or crowns are therefore a good choice for back teeth (like molars), as aesthetic problems, if they do occur, are not as visible in your smile.
All-metal crowns are a good, strong option, as they only require minimal natural tooth material to be removed. These crowns also cause minimal wear on opposing teeth; are durable; and rarely chip or break. This means they often last the longest of all the crown materials and make them a good choice for patients with teeth clenching or grinding habits (bruxists). All metal crowns are a good material for back teeth (molars).
However, the main drawback of all metal crowns is that they do not match the natural colour of your teeth, and so are more visible.
Furthermore, as the price of gold increases, the price of gold crowns follows suit.
During the consultation appointment, we will assess your tooth for its suitability for crowns, and then discuss with you about the pros and cons for each option. We will then give you our recommendation. We will also discuss with you all the steps required prior to the crown preparation appointment. For example, if there is less than optimal tooth structure left, we may need to place a post, and/or a core filling first. Sometimes, a root canal treatment may be required due to infection, or as a precaution.
During the crown preparation appointment, your tooth will be ground down (the amount of tooth removed varies according to the material of the crown). An impression of your tooth will be made and the specific shade of your existing tooth will be measured. A temporary crown will be made and placed on your tooth until your next appointment.
As a temporary crown is a lot weaker than your normal tooth, you should eat softer foods and avoid chewing on the tooth. While flossing, avoid pulling the floss upwards as it may loosen the crown. Instead pull the floss through your tooth.
After the first appointment, we will instruct laboratory technicians to create your crown based on the impressions and colour information taken during the appointment. The temporary crown will be removed during the second appointment and the underlying tooth will be cleaned. A final crown will be tried on for fit. We will check whether the crown is sitting fully down onto the natural tooth; that it has the right colour shade; and that it gives the correct bite. If not, the crown will be adjusted accordingly. Once the criwn is satisfactory, it will be cemented in place.
After your final treatment, you will be able to eat and chew normally right away. You may experience some sensitivity or soreness after a crown treatment, which should subside within a few days or weeks.
How long your crown will last will depend upon the material it is made of; the condition of the tooth’s nerve; the size and strength of the remaining natural core of your tooth; the quality and expertise of your dentist and lab technician; and the pressure placed on the crown (e.g. whilst eating).
Besides that, the long-term success of your crown can be governed to a large extent by your daily oral hygiene regime. It is important to keep the margins between your tooth, gum and the crown clean. Plaque can build up in the area between the crown and the tooth, resulting in tooth decay. As tooth decay progresses, the crown has to be removed for the decay to be treated and a new crown to be made, resulting in additional cost.
Gum disease can also lead to the loss of bone and tissues in your remaining tooth, weakening the support of the core and the crown may fail as a result. Therefore, regular dental visits are essential to prevent decay and gum disease and to identify any problems at an early stage.
If your dental situation is highly complex, and it is in your best interests to see a specialist,
we will refer you to a Prosthodontist (a specialist in dental rehabilitation).
At Dentist Mandy, we are committed to providing you with the best dental treatment and advice to help you make informed decisions about all aspects of dental crowns.